Provider Demographics
NPI:1356952147
Name:SALAMI, MOHAMED H (CNP)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:H
Last Name:SALAMI
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6892 FOREST RUN DR
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-1392
Mailing Address - Country:US
Mailing Address - Phone:419-508-6706
Mailing Address - Fax:
Practice Address - Street 1:6135 TRUST DR STE 230
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9360
Practice Address - Country:US
Practice Address - Phone:567-703-9869
Practice Address - Fax:419-214-1900
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-14
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0026935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty